Enterprise Risk Adjustment Analyst
Company: VirtualVocations
Location: Toms River
Posted on: November 19, 2024
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Job Description:
A company is looking for an Enterprise Risk Adjustment Analyst
to manage data extracts and perform Encounter Data submissions for
various healthcare programs.
Key Responsibilities:
Create and manage data extracts for Medicare, Medicaid, and ACA
Commercial programs
Review submission reports and reconcile internal data with data
submitted to CMS/DHS
Perform root cause analysis to address potential gaps in risk
scores
Required Qualifications:
Bachelor's degree in business or related field with 5 years of
relevant experience, or 9 years of related work experience in lieu
of a degree
Strong knowledge of Claims, Encounters, and Supplemental Data
Expert knowledge of CMS rules and guidance for Risk Adjustment
Submissions
Experience with Medicare, Medicaid, and ACA Commercial Data
Submissions
Proficiency in extracting data from relational databases and
performing data analysis
Keywords: VirtualVocations, Bethlehem , Enterprise Risk Adjustment Analyst, Professions , Toms River, Pennsylvania
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